I have seen the disease in children of nearly all ages. I once saw it in a child of six weeks old. It was preceded by the cholera infantum. The sudden deaths which we sometimes observe in infancy, I believe, are often produced by this disease. Dr. Stoll is of the same opinion. He calls it, when it appears in this form, "apoplexia infantalis[46]." [46] Prælectiones, vol. I. p. 254. In the month of March, 1771, I obtained a gill of water from the ventricles of the brain of a negro girl of nine years of age, who died of this disease, who complained in no stage of it of a pain in her head or limbs, nor of a sick stomach. The disease in this case was introduced suddenly by a pain in the breast, a fever, and the usual symptoms of a catarrh. Dr. Wistar informed me, that he had likewise met with a case of internal dropsy of the brain, in which there was a total absence of pain in the head. Dr. Carson informed me, that he had attended a child in this disease that discovered, for some days before it died, the symptom of hydrophobia. Dr. Currie obtained, by dissection, seven ounces of water from the brain of a child which died of this disease; in whom, he assured me, no dilatation of the pupil, strabismus, sickness, or loss of appetite had attended, and but very little head-ach. The causes which induce this disease, act either _directly_ on the brain, or _indirectly_ upon it, through the medium of the whole system. The causes which act _directly_ on the brain are falls or bruises upon the head, certain positions of the body, and childish plays which bring on congestion or inflammation, and afterwards an effusion of water in the brain. I have known it brought on in a child by falling into a cellar upon its feet. The _indirect_ causes of this disease are more numerous, and more frequent, though less suspected, than those which have been mentioned. The following diseases of the whole system appear to act indirectly in producing an internal dropsy of the brain. 1. _Intermitting_, _remitting_, and _continual_ fevers. Of the effects of these fevers in inducing this disease, many cases are recorded by Lieutaud[47]. [47] Historia Anatomica-Medica, vol. II. My former pupil, Dr. Woodhouse, has furnished me with a dissection, in which the disease was evidently the effect of the remitting fever. That state of continual fever which has been distinguished by the name of typhus, is often the remote cause of this disease. The languor and weakness in all the muscles of voluntary motion, the head-ach, the inclination to rest and sleep, and the disposition to be disturbed, or terrified by dreams, which are said to be the precursors of water in the brain, I believe are frequently symptoms of a typhus fever which terminates in an inflammation, or effusion of water in the brain. The history which is given of the typhus state of fever in children by Dr. Butter[48], seems to favour this opinion. [48] Treatise on the Infantile Remitting Fever.